It's difficult to view multiple sets of vital signs taken on the same day for a patient on the "Numeric" tab. They are sorted by diastolic, temp, and so forth, so you have to match all the 1st's, 2nd's, and so forth. I think simply adding the column of "time" would solve this problem, as one could then sort on time. Maybe a new entry box could be added to the vitals popup so the user could either accept the current time for the vitals being entered, or change it to a different time.
What's the context for this? If you record vitals, they are inserted into the text with a timestamp. Numeric results don't display time information because most of it comes from HL7 import. I can't easily add another column because lots of things rely on the current data structure ( HMGs, graphs etc ) So, why do you want time data for? If you have a patient that you're monitoring over an hour or so, you can just use the timestamps that are provided with capturing the vitals. If you want to monitor over a longer period of time, then that sounds like in-patient monitoring and not ambulatory care. There is a created timestamp field associated with all numeric results .. so for vitals, it could be pulled out into a separate display ... but I need to know the reasons.
On the Numeric tab, vitals signs are secondarily grouped by type (diastolic, etc) when clicking on the date column header. When viewing multiple sets of vitals from the same day, the user has to match the first diastolic, first systolic, first temp, and so forth, then the second, and there's no time, so the user still only knows what order this sets of vitals were taken in. True, you could look through all the patient's consults for the times these sets of vitals were taken, but doesn't that sort of defeat the purpose of having a table of the patient's vital signs? I see that the CREATED column of the DIGITAL table records time and date. Would it be possible to modify the Date column of the Numeric tab to include Time and date, so that time would be visible, and the user could do a "type search" to limit the view to a set of vitals with a particular date and time?
It's still unclear to me as to why you are recording vitals more than once a day. If you don't like the grouping together of the diastolic etc for a particular day ( I hadn't noticed that as I don't normally do vitals more than once a visit ), then I can change the sql so that it no longer does that.
With Urgent Cares getting the a few "Quite Sick" patients, possibly needing transfer to hospital .... getting more than one BP and HR when spending 1/2 a day getting worked up at an Urgent Care center is a good idea.
Sure, an sql adjustment that groups by date and time, so that the diastolic, systolic, pulse, temp and so forth for a given time display altogether in the list would be fine. It would still be good to be able to see the time and date the vitals were taken on the Numeric tab. As Jason points out, folks can spend many hours in uc and ER. A lot of ER's use automated bp cuffs, and fancy vital sign equipment ... could just send the vitals back to synapse in HL7! However, failing that, the vitals are not usually taken in exactly regular intervals. So as I am scanning lists of vitals, particularly of a long visit where a patient may have gotten injectable medications, nebulizer treatments, IV's, etc., I want to see timed sets of vitals. It's not a burning issue currently, but if possible to simply display the date and time the vitals were taken, that would be good.
If you are taking a series of vitals they should be inserted into the notes with their timestamps. Adding a time to the numeric results just results in more clutter for the 99.9% of the time you don't need to see the time. My preference would be to add a separate tab up for vitals ... or graph them instead in time series chart.
Putting vitals on a separate tab or graphing them in a time series chart would be fine. Matter of fact, a time series chart might be preferable. I agree that vital sets with a time stamp need to be primarily recorded in a consult. However, viewing vital sets for complex patients over a longer period of time makes more sense when you can see the times. Let's say you have a hypertensive asthmatic patient that presents somewhat regularly, and often gets IV corticosteriods with multiple albuterol or duoneb nebulizer treatments. What tends to be the pattern of her BP and pulse... does if often spike in the first 30 min, but rarely goes higher after 2-3 hours? More important in an asthmatic example is the overall pattern of peak flow to neb tx. It could be that I'm splitting hairs, and that simply viewing consults for visits that have a lot of vital signs is fine.
B45 server now re-orders the results so that you shouldn't get them grouped as before. I meant graphing over one day ... I can't see how easily it would be to graph over months and minutes on the same graph.
